4673 Stonecliffe Dr - Inspection FormCity of Fa an
Residential Sanitary Sewer Service
Compliance Inspection
Date / !_. Time
Name
PIP Number
House Number
4" to 6 "Transition:
Owner
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
1 Disk #
cupant Signature
Service Lateral Inspection Findings
White Copy: Property Owner
Street Name
• ��? Al o am
Pm
r,
/
Alternafye Mailing Address Phone / )
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks 1 Entered S L at °
Roots
Poor Pipe Joints
Mineral Deposits J r r
--
.l
� Sag/Pipe Deflection �� . _� �' �r _ -7 -
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
.5 —1 O am
Time a b
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
,. Fina1 Cleanout: t •
Pink Copy: SEH
Number
Correctly
Discharged
Notes
"
' ' 0X,77 ,.:1-2:<-5Y /)� ` )
/ > }}
'
Total
Incorrectly
Unknown
Sump pumps
/
Foundation drains
��
X
Roof drains
( i
City of Fa an
Residential Sanitary Sewer Service
Compliance Inspection
Date / !_. Time
Name
PIP Number
House Number
4" to 6 "Transition:
Owner
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
1 Disk #
cupant Signature
Service Lateral Inspection Findings
White Copy: Property Owner
Street Name
• ��? Al o am
Pm
r,
/
Alternafye Mailing Address Phone / )
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks 1 Entered S L at °
Roots
Poor Pipe Joints
Mineral Deposits J r r
--
.l
� Sag/Pipe Deflection �� . _� �' �r _ -7 -
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
.5 —1 O am
Time a b
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
,. Fina1 Cleanout: t •
Pink Copy: SEH